Medical Bills and Lien Itemization Table
When treatment has ended or the client has reached maximum medical improvement and you are assembling specials for a demand, or when lien amounts need reconciling before settlement disbursement.
Medical specials are the backbone of most personal injury demands, and they are also where demands lose credibility. A specials figure that includes duplicate charges, unrelated visits or a provider with no records invites the adjuster to discount everything else. On the other side of the case, liens that were never accounted for can derail a settlement at disbursement. Both problems come from the same source: bills, EOBs and lien letters that were never reconciled against each other.
This prompt reconciles them. From pasted bills, EOBs, payment records and lien notices, Claude builds a provider-by-provider table showing dates of service, amounts billed, adjustments, amounts paid, the payer, the outstanding balance and any lien, with a source cite for every figure. It totals each column with the arithmetic shown, then flags duplicates, unmatched charges and payments, treatment outside the claimed period, missing records and payers who appear to have paid without asserting a lien.
The table organizes numbers; it does not decide which amounts are recoverable. Whether a plaintiff can claim billed or paid amounts, and whether a lien is valid or reducible, depends on jurisdiction, payer type and plan terms. The prompt leaves those questions to you. Check every total against the source documents, and treat the table as a draft for attorney review.
The Prompt
I represent [CLIENT NAME], injured on [DATE OF INCIDENT] in a [TYPE OF INCIDENT] in [JURISDICTION]. I am preparing medical specials for a demand and need an accurate itemization. <document name="bills"> [PASTE ITEMIZED BILLS AND BILLING LEDGERS FROM EACH PROVIDER] </document> <document name="eobs_and_payments"> [PASTE EXPLANATIONS OF BENEFITS, PAYMENT LEDGERS, MED-PAY OR PIP PAYMENT RECORDS] </document> <document name="lien_notices"> [PASTE LIEN NOTICES, REIMBURSEMENT CLAIMS AND LETTERS OF PROTECTION] </document> Build: 1. Itemization table: Provider | Dates of service | Description or CPT/code if shown | Amount billed | Adjustments or write-offs | Amount paid | Payer (health insurer, government program, med-pay/PIP, patient, none) | Outstanding balance | Lien or reimbursement claim | Source (document and page). 2. Totals: billed, adjusted, paid, outstanding, and total asserted liens, each by provider and overall. Show the arithmetic. 3. Discrepancies: duplicate charges, dates of service outside the treatment period, charges with no matching EOB, payments with no matching charge, balances that do not reconcile, and bills that look unrelated to the injuries claimed: [INJURIES CLAIMED]. 4. Lien review: every payer that appears to have paid but has not yet asserted a lien or reimbursement claim, every asserted lien with its stated amount, and any lien amount that differs from the payments shown. Do not state whether a lien is valid or enforceable. 5. Missing records: providers referenced in the records with no bill, and bills with no EOB. Use only figures from the documents and cite each one. Write "not shown" rather than estimating. This is a draft for attorney review; totals must be checked against the source documents, and the treatment of billed versus paid amounts and liens under [JURISDICTION] law must be verified.
Example Output
A provider-by-provider table of billed, adjusted, paid, outstanding and lien amounts with source cites, reconciled totals, and flags for duplicates, missing EOBs and unasserted liens.
Illustrative example — names, figures, and facts are fictional.
MEDICAL SPECIALS AND LIEN ITEMIZATION (DRAFT FOR ATTORNEY REVIEW) Client: Teodora Lindqvist | DOI: 02/06/2026 | Injuries claimed: cervical strain, left shoulder sprain 1. ITEMIZATION Provider | DOS | Billed | Adjust. | Paid | Payer | Balance | Lien | Source Hospital A, ED | 01/18/26; 02/06/26 | $6,412.00 | $3,980.10 | $2,431.90 | Health plan | $0.00 | n/a | BILL-01 p.2; EOB-01 Imaging Center B | 02/20/26 | $2,150.00 | $1,402.00 | $748.00 | Health plan | $0.00 | n/a | BILL-02; EOB-02 PT Clinic C (18 visits) | 03/02-05/28/26 | $5,040.00 | not shown | $0.00 | none | $5,040.00 | LOP $5,040.00 | BILL-03; LOP-01 Health plan reimbursement | n/a | n/a | n/a | n/a | n/a | n/a | $3,179.90 | LIEN-01 2. TOTALS Billed: $6,412.00 + $2,150.00 + $5,040.00 = $13,602.00 Adjusted: $3,980.10 + $1,402.00 = $5,382.10 (PT Clinic C: not shown) Paid: $2,431.90 + $748.00 = $3,179.90 Outstanding: $5,040.00 Asserted liens and LOP balances: $5,040.00 (LOP) + $3,179.90 (plan) = $8,219.90 3. DISCREPANCIES - PT Clinic C bills 03/14/26 twice at $280.00 (BILL-03 lines 6 and 7). Possible duplicate. - Hospital A bill includes a 01/18/26 ED visit ($385.00), before the incident. It is included in the $6,412.00 total above; confirm relatedness or remove it. - Imaging Center B: no records or report provided, only the bill. 4. LIEN REVIEW - Health plan asserted $3,179.90, matching payments shown. - Med-pay or PIP: no payment records provided. Confirm whether the client's auto policy carries either coverage and whether that carrier claims reimbursement. 5. MISSING RECORDS - Orthopedic referral (03/01/26) mentioned in PT notes; no bill provided.
Tips
- •Ask each provider for an itemized ledger, not a balance statement. Summary bills hide duplicate charges and write-offs.
- •Paste EOBs separately from bills so Claude can match payments to charges and flag what does not reconcile.
- •Check the unasserted-lien list against every payer you know about. A government program or health plan that paid but has not asserted a claim can still surface at disbursement.
- •Feed the verified table into the demand letter drafter and later the settlement breakdown drafter, so all three use the same numbers.
- •Recalculate every total and check every source cite yourself before sending; the table is a draft for attorney review.
Frequently Asked Questions
Should the demand use billed amounts or paid amounts?
That depends on your jurisdiction's collateral source and damages rules, which differ significantly and continue to change. The table reports both, plus adjustments, so you can present whichever figure is appropriate and anticipate the adjuster's argument. Verify the rule that applies in your case before deciding which totals go into the demand.
Can Claude tell me whether a lien is valid or can be reduced?
No, and the prompt tells it not to try. Lien validity and reduction turn on the payer type, plan documents, statutes and sometimes federal law that governs certain health plans and government programs. The table shows what was paid and what was asserted so you can evaluate each claim and negotiate with the right information.
What if a provider sends only a balance statement?
Claude will itemize what is shown and flag that the bill is not itemized. Request an itemized ledger with dates of service and codes. Summary statements hide duplicate charges and write-offs, and adjusters frequently challenge specials that are not supported by itemized bills.
Is it safe to paste medical bills into Claude?
Medical bills contain sensitive health information. Redact identifiers you do not need, such as member IDs and dates of birth, follow ABA Model Rule 1.6 and your firm's AI policy, and use a Claude plan with appropriate data protections and contractual terms for health information. Confirm your setup meets any obligations that apply to your practice.
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